Group restates policy on emergency contraceptives and teens

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In the United States, emergency contraception -- also known as the "morning-after" pill -- is available by prescription to all females of child-bearing age.

A lot of young people don't know that, however. So today, the American Academy of Pediatrics on its website is urging its members to get the message out.

"Physicians can play an important role in counseling patients and providing prescriptions for teens in need of emergency contraception for preventing pregnancy," said the organization in a statement that will be published in the December issue of its journal, Pediatrics.

Why the need to restate a policy the organization originally issued in 2005?

"We realized that a lot of young people don't know that emergency contraception is available and legal," said Cora Breuner, a physician and professor of adolescent medicine at Seattle Children's Hospital.

"They don't know where to get it or how much it costs. There's not a lot of information out there for these kids."

A Supreme Court decision in the 1970s said females of childbearing age -- of any age -- weren't required to get the consent of their parents before obtaining contraception, but many still don't know that, either.

The academy's statement comes amid continued legal wrangling between federal officials and reproductive rights advocates over allowing morning-after pills to be sold over the counter, an argument that has been waged for years and is not yet resolved.

There are about 750,000 teenage pregnancies annually in the United States, 85 percent of which are not intentional. That's the highest number of any developed country, Dr. Breuner said.

Adolescents are more likely to use emergency contraception if prescribed in advance, she said, while studies have found no evidence that its availability increases sexual activity.

If used within 120 hours after having unprotected sex, these morning-after pills -- Plan B One Step, Next Choice and several others -- are the only methods available to prevent unwanted pregnancy.

In its statement, the academy also said it is important for teens to understand that emergency contraception doesn't protect against sexually transmitted infections, "and pediatricians should discuss the importance of STI testing or treatment if needed."

The group also encouraged pediatricians to advocate for better insurance coverage and increased access to emergency contraception, although in some states -- not in Pennsylvania -- pharmacists and pharmacies can refuse to fill the prescriptions, according to the Guttmacher Institute, an organization that promotes sexual and reproductive health through research, policy analysis and public education.

Just how many refuse is unclear, but in a recent survey researchers had callers posing as 17-year-olds seeking emergency contraception in five cities. According to the survey published in the Pediatrics journal, 80 percent of the pharmacies said emergency contraception would be available, with a prescription, on the day of the call. Another 19 percent said it would be impossible to obtain it, even with a prescription, because of the caller's age.

Then there's the ongoing issue of over-the-counter access.

In 2011, after years of research, delays and lawsuits, the Food and Drug Administration agreed to make Plan B One Dose available over the counter, but U.S. Health and Human Services Secretary Kathleen Sebelius overrode that decision, claiming more research was needed.

That prompted the Center for Reproductive Rights to add Ms. Sebelius to its lawsuit. Now that President Barack Obama has been elected to a second term, "We're still waiting to hear what she's going to do," said Elizabeth Nash, states issues manager of the Guttmacher Institute.

In the meantime, the American College of Obstetricians and Gynecologists issued its opinion Tuesday that birth-control pills should be sold over the counter, like condoms. Although that would make them more accessible, there remains the question of how much women would have to pay for them, in comparison to insurance coverage for prescription pills.

We realized that a lot of young people don't know that emergency contraception is available and legal."
-- Cora Breuner, physician and professor of adolescent medicine
health

Mackenzie Carpenter: mcarpenter@post-gazette.com or 412-263-1949.


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